Pericardial Disease
In this article we explore pericardial disease in detail, explaining what pericardial disease is and taking a closer look at pericarditis.
If you would like to talk to a solicitor about pericardial disease, including pericarditis, please get in touch with us at Glynns Solicitors. It may be that your condition (or your loved one's condition) was not managed properly by medical practitioners, resulting in complications that could have been avoided with better medical care. If so, you could be entitled to take legal action against those responsible.
What is pericardial disease?
Pericardial disease is a broad term that relates to any condition affecting the pericardium.
The pericardium is a sac filled with fluid which surrounds the heart and the roots of the major blood vessels.
The main types of pericardial disease are pericarditis, pericardial tamponade, pericardial constriction, and effusive constrictive pericarditis.
Pericarditis is the most common form of pericardial disease. The NHS predicts that 5% of people who attend Accident and Emergency for chest pain have pericarditis. It can affect anyone of any age, but it more common in males and in young adults.
Pericarditis
Pericarditis is when the pericardium, the fluid-filled sac surrounding the heart, becomes swollen or inflamed. There are three different types of pericarditis:
1. Acute pericarditis is when symptoms arise and last for less than three months. Often symptoms will disappear within a week if treatment is provided.
2. Chronic pericarditis is when symptoms arise and last for more than three months.
3. Recurring pericarditis is when episodes of acute pericarditis return repeatedly.
Pericarditis is not normally considered to be a serious condition. It can be successfully treated with medication and a patient will not usually need to be admitted to hospital. However, complications can occur, and some of these are potentially life-threatening. This is reviewed in more detail later in the article.
Causes of pericarditis
It is not always known why pericarditis happens. In fact, around 90% of acute pericarditis cases have no known cause. In most other cases pericarditis is caused by a viral infection. This can include viral infections such as: the common cold, the flu, pneumonia, glandular fever, bronchitis, meningitis and hepatitis C.
Pericarditis does have other causes, although these are fairly rare. They include:
- Heart attack
- Auto-immune conditions such as lupus
- Bacterial infections
- Kidney failure
- Cancer
- Underactive thyroid
- Traumatic chest injuries – e.g. from a road traffic accident
- Surgical injuries to the pericardium
- Medication such as chemotherapy or penicillin
Auto-immune conditions are more specifically thought to cause recurring pericarditis. Auto-immune conditions are when the immune system mistakes something inside the body as a threat and attacks it.
In the case of recurring pericarditis, it would seem the immune system experiences a delayed reaction to a case of acute pericarditis. This means that the patient experiences acute pericarditis and recovers. But some weeks, months or even years later the immune system kicks in, either mistaking the tissue as being unhealthy, or responding to a fragment of virus that is still present inside the tissue. The process triggered by the immune system causes inflammation in the pericardium, resulting in another episode of pericarditis.
Symptoms of pericarditis
The main symptom of pericarditis is chest pain. This can be a dull ache, or a sharp stabbing pain behind the breastbone. The pain will likely be on the left-hand side of the chest and may extend up to the left shoulder and neck. People with pericarditis normally find the pain is worse when lying down, breathing in, coughing and eating.
There may be some other symptoms associated with pericarditis, but this depends largely on the underlying cause. For example, if an infection is to blame there may be a fever. The inflammation surrounding the heart can also lead to fatigue, nausea, shortness of breath and swelling around the legs and abdomen.
Diagnosing pericarditis
Pericarditis can be diagnosed with a number of simple tests. Firstly, a doctor should listen to a patient's heart with a stethoscope to check for any rasping sounds. Secondly, an electrocardiogram (ECG) should be carried out to check whether the electrical activity of the heart has changed, as usually happens with pericarditis.
If these tests show no abnormalities but symptoms persist, imaging tests such as a CT scan or echocardiogram may be performed. Other tests may also be useful to discover the underlying cause of pericarditis – for example, a blood test can check for infection, or a sample of fluid may be drained from around the heart to check for irregularities.
Treating pericarditis
Most cases of pericarditis can be treated with medication and admission to hospital will not be necessary.
The first medication of choice when treating pericarditis is non-steroidal anti-inflammatory drugs (NSAIDs). One of the most common types of NSAIDs is ibuprofen and it is the preferred mode of treating pericarditis.
If NSAIDs do not work, a patient may be given colchicine, which reduces inflammation by killing cells. If the body still does not respond, the patient may be prescribed corticosteroids.
However, a patient will need to be admitted to hospital if there are at risk of developing complications as a result of pericarditis. This might include if:
- There are signs of a serious infection
- There are signs of heart damage
- There are signs of a build-up of fluid around the heart
- The patient is taking anti-coagulant medication
Pericarditis complications
There are occasions when pericarditis will lead to other forms of pericardial disease, some of which can be very serious. This includes the following three conditions:
1. Chronic effusive pericarditis, which is when a large amount of fluid builds-up inside the pericardium.
2. Chronic constrictive pericarditis, which is when the pericardium tissue suffers scarring and becomes hardened.
3. Cardiac tamponade, which is when a build-up of fluid inside the pericardium makes it difficult for the body to pump blood around the body.
All of these conditions require admission to hospital and prompt medical treatment. In particular cardiac tamponade is a medical emergency that can become life-threatening within a matter of minutes. Immediate treatment is therefore required.
Pericardial disease and medical negligence
If medical practitioners fail to treat pericarditis and it leads to complications such as cardiac tamponade (which could have been avoided with medical treatment), there may be grounds for a medical negligence claim. Furthermore, if medical practitioners fail to diagnose and treat a life-threatening form of pericardial disease, such as those mentioned above, there may be grounds for a medical negligence claim.
Contact a solicitor today
If you or your loved one has suffered injuries because doctors failed to treat pericardial disease, please get in touch with us at Glynns Solicitors for expert legal advice.
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